Individual
DR. LORI A. MAGOULAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., R.D.
Contact information
Practice address
39 AVENUE AT THE COMMON, SUITE 106, SHREWSBURY, NJ 07702
(732) 544-1661
(732) 544-9022
Mailing address
PO BOX 7925, SHREWSBURY, NJ 07702-7925
(732) 544-1661
(732) 544-9022
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
705971
NJ
133V00000X
Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
942955
AETNA PROVIDER ID
NJ
01
—
P2970225
PROVIDER ID NUMBER
NJ
Enumeration date
04/18/2007
Last updated
01/12/2015
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